Over hundreds of years, the female form has been seen as a figure of perfection in art and sculpture but in the everyday world, a woman’s body usually becomes the cause of a lot of stress and worry. So, what can women do to care for themselves in the long-term?
There is no magic cure for female ailments and this is why efforts to improve general well-being is so important. The key is to have awareness and to lead a healthy, fulfilling lifestyle that works for you.
Consultant obstetrician and gynaecologist at the OBGYN Women’s Specialist centre in Subang Jaya and senior lecturer at Monash University School of Medicine, Dr. Sharad Ratna, reveals details on some of the most common women’s health conditions.
Menopause, which is the time in a woman’s life when she stops ovulating as well as perimenopause which is the transition phase leading up to it, can be a rollercoaster ride. It’s not a walk in the park for many women mainly due to two points: the impact of symptoms on quality of life and an increased risk for certain conditions like heart disease or osteoporosis which can also be due to age.
For troublesome symptoms, hormone replacement therapy (HRT) can be considered for short-term relief over a period of one to two years. Dr. Sharad explains, “In the short term it has been found to be beneficial for early symptoms like hot flushes, night sweats and dryness.”
Another option is to take plant estrogens found in food sources such as soy, black cohosh or red clover. Every woman manages menopause in a different way, some through lifestyle measures alone. Moreover, the balance of risks and benefits for treatment options such as HRT varies for each individual.
Cool tips for hot times
- Stress and anxiety relief: Meditation, yoga, swimming, taking up a new hobby or interest.
- Be active in the day and get up at around the same time each day so that it’s easier to fall into deep sleep at night. Your bedroom should be dim, quiet and cool to quell those sleep disturbances.
- Use a vaginal moisturizer or vaginal estrogen for dryness.
While not exclusive to women, breast cancer is the most common cancer for women, globally. Genetic factors, family history and reproductive factors like getting your period early or your menopause late are some of the known risk factors. Early detection is crucial to improving survival rates.
Breasts of all shapes and sizes need to be cared for in order to stay healthy. Dr. Sharad shares the following tips for women:
• A monthly breast self-examination.
• Clinical breast examination by a gynaecologist or breast specialist
• Ultrasound scanning of the breast on a yearly basis.
• Women aged 50 and above should get mammograms every 2 years and women below that age should talk to a doctor on how often to have a mammogram.
If you’re still menstruating, arrange your monthly self-examination for a few days after your period has ended. Here’s how to go about it:
1. Mirror: Observe your breasts for any swelling, puckering, dimpling or other unusual changes, first with your hands on your hips, then clasped behind your head. Squeeze the nipples to detect any discharge.
2. Shower: While standing in the shower, run your finger pads over each breast in a circular motion (the size of a coin) to detect lumps. To ensure the entire breast is covered, slowly move your hand up and down from above to below the breast or in concentric circles from the outer edge to the nipple. Vary the pressure of touch for different tissue thicknesses.
3. Lying down: Lie down with a towel or pillow under one shoulder so that your breast is evenly flattened out. Repeat the steps taken in the shower.
Polycystic Ovarian Syndrome
Polycystic ovarian syndrome is a disorder where ovulation is chronically irregular or absent, as regulatory hormones fail to cyclically rise and fall and excessive androgens are produced in the body.
According to Dr. Sharad this is one of the causes of irregular periods. Weight management is highly recommended for women who are overweight and having irregular periods. The birth control pill is used for long-term management, which Dr Sharad says is also “fantastic for long-term prevention of ovarian cancer, endometrial cancer and benign breast disease”.
Endometriosis involves the tissue lining the uterus — endometrial tissue — growing outside of the uterine cavity. They remain functional and sloughs off as tissue and blood and cause inflammation, scarring and pain in the pelvic area.
Sexually Transmitted Infections (STI)
Douching “does not prevent sexually transmitted infections or pregnancy”, explains Dr. Sharad. Good bacterium that normally reside in the vagina keeps the environment acidic, a protective barrier against infection by ‘bad’ bacteria. Any disruption to this effect of normal flora crowding out ‘bad’ bacteria decreases protection against sexually-transmitted infection (STI).
Having a sexually-transmitted infection like genital herpes, Chlamydia or Gonorrhea increases the risk of acquiring HIV (human immunodeficiency virus) because of breaks or inflammation of the genital tract lining and skin.
Safer Sex Practices
• Both you and your partner may choose to undergo STI testing to know your status.
• Always use a condom during vaginal or anal intercourse. A dental dam or cut-open condom can be used to prevent direct contact during oral sex.
- The most effective method of preventing STI’s is to abstain from having vaginal, oral or anal sex.
Pelvic Inflammatory Disease
Pelvic inflammatory disease is an infection of the upper genital tract that could involve parts such as the ovaries, endometrium, uterine muscular wall and the lining of the pelvis below the abdominal cavity. The main risk factors are failing to observe safe sex practices and contracting sexually-transmitted infections.
Cervical cancer is mainly caused by persistent infection of high-risk types of human papillomaviruses. Many sexually active men and women can get infected with HPV, which mostly clears up on its own but not always. Safe sex practices, including the use of condoms and having a mutually monogamous relationship, are strongly advocated. Precancerous cells in the cervix are detected through the Papanicolaou test, also known as a pap smear.
Stress Urinary Incontinence
Stress incontinence is triggered by actions that cause the pressure in the bladder to exceed the limit at which urinary sphincters are closed. Underlying weakness in bladder control muscles can be improved by regular pelvic muscle exercises. Weight management and quitting smoking will help control the frequency of episodes.
Pelvic Floor Exercises
Incorporate a set of each into your daily routine, three to four times a day.
• Slow contractions: Sitting or lying down with knees bent, pull in your pelvic floor muscles slowly and hold the contraction for as long as you can. Rest for 4 seconds before repeating for a set of 10 slow contractions.
• Quick contractions: Practise pulling in your pelvic floor muscles in quick succession, holding it in for just 1 second before relaxing.
Unlike cervical cancer, no screening tool exists for early detection of ovarian cancer. However, recurring symptoms to watch out for include persistent bloating and increased size of the abdomen, pelvic and abdominal pain as well as urinary urgency. Ovarian cancer, is more common in older women, and may spread to other sites in the body if not treated early on.
High Blood Pressure and Diabetes During Pregnancy
Towards the later stages of pregnancy, gestational diabetes can develop when, the pregnant woman’s body fails to moderate high blood glucose levels. Women with untreated gestational diabetes risk getting pre-eclampsia which is defined as high blood pressure after the 20th week of gestation with protein detected in urine, a condition that may necessitate induced delivery of the baby.
In a Nutshell…
“The general take-home message is that you have to have a good lifestyle. It all comes back to that,” says Dr. Sharad, who also emphasises the importance of exercise, a healthy diet, not smoking, and avoiding excessive alcohol consumption as well as practising safe sex.
Stress management and spirituality — on top of what is mentioned above — lowers the risk of getting other diseases common in women too such as colorectal cancer, depression and dementia.
1. Always write down concerns or questions you want to ask your healthcare provider in a personal notebook with your health management plan and list of current medications or supplements, if any.
2. Ask for professional support and guidance in implementing lifestyle or behaviour changes that you can’t handle on your own to set out an action plan or “contract”.
3. Knowing how to deal with personal stress or who to reach out to your support network sets the foundation for a healthy outlook, enabling you to focus on the next steps you can take.